全玻璃体切除术在眼外伤手术中的应用  

Total vitrectomy used in traumatic globe

作　　者：陈子林[1] 刘文[2] 张敏[3] 于强[2] 邱少杰[1] 黄素英[2] 戴玲 钟凯仁[1] 梁继武[1] 陈敏瑜[3] 钟广斌[3] 叶润才[3] 

机构地区：[1]惠州市中心医院眼科,广东惠州516001 [2]中山大学中山眼科中心,广东广州510060 [3]东莞市人民医院眼科,广东东莞523018 [4]东莞光明眼科医院,广东东莞523000

出　　处：《眼外伤职业眼病杂志》2005年第5期333-337,共5页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的　探索将全部玻璃体切除的方法在眼外伤手术中应用的价值及效果。方法　回顾性序列病例研究。85例(85眼)眼外伤中,闭合性眼外伤17例,开放性眼外伤68例。其中眼内异物伤3 2例、巨大裂孔17例和外伤性视网膜脱离3 4例。增生性玻璃体视网膜病变分级:A级6例,B级8例,C级8例,D级12例。采用标准经睫状体平坦部三通道玻璃体切除术,并通过巩膜压陷法切除基底部玻璃体。结果　在无晶状体眼和有晶状体眼,充分全玻璃体切除术78例,部分全玻璃体切除7例。最终随访81例,初次手术成功73例(90 . 12 %) ,再次玻璃体视网膜手术4例,最终视网膜保持平复77例(95 . 0 6%)。视力在0 . 0 6以上者42眼,与术前相比差异具有非常显著意义(P <0 . 0 0 5 )。结论　眼外伤手术中全玻璃体切除技术切实可行,可减少玻璃体残留所致的并发症,提高手术效果。Objective To investigate the value and the effect of total vitrectomy in the surgery of globe injuries.Methods Prospective consecutive study was adopted.Closed-globe injury was 17 cases and open-globe injury 68 cases in the total 85 cases,which included intraocular foreign body in 32 cases,giant retinal break 17 cases and traumatic retinal detachment 34 cases.The classification of proliferative vitreoretinopathy(PVR) was grade A in 6 cases,B in 8 cases,C in 8 cases,D in 12 cases.Among them,there were anterior PVR in 13 cases.The standard three port pars plana vitrectomy was performed,and the vitreous in the base and pars plana was thoroughly excised by using a scleral indentation.Results The total vitrectomy was performed in 78 cases and partial in 7 cases. 81 cases were available in the last follow up visiting.Retinal reattachment was 73 cases(90.12%) after initial vitrectomy.Four patients underwent a second vitreoretinal surgery.The retina maintained attachment in 77 eyes (95.06%) at last.The visual acuity was ≥0.06 in 42 eyes,which had significant difference contrasted to that of preoperation (P<0.005).Conclusion The total vitrectomy is a feasible method in the sugery of globe injuries,which can decrease the complications of vitreous remainder and improve surgical effect.

关 键 词：眼外伤 玻璃体手术 前段增生性玻璃体视网膜病变 视网膜脱离 玻璃体基底部 

分 类 号：R779.6[医药卫生—眼科]